Archive for the ‘Ethics’ Category

For years, the international adoption program in Russia has offered thousands of children facing bleak futures the chance to thrive in the homes of loving US adoptive parents. To make a political statement [filled with collateral damage], Russia has now closed this avenue. Additionally, Russia’s throw-in comment that part of its reasoning for this decision is that children have been abused in significant numbers after arriving in the US is nothing more than a nonsensical attempt at justification.

But the Russia ban also raises other issues and exposes long-held myths regarding international vs. domestic adoption. Some adoptive parents are drawn to international adoption out of a fear that domestic adoption means a less secure adoption: one that involves the continued threat that biological parent(s) will “take the child away” after placement. The reality is that if properly handled – with separate lawyers for biological and adoptive parents – and complete documentation/court proceedings, this is beyond a remote possibility. Other times, adopters here in the US are under the false belief that it takes years to locate a suitable situation [birth mother] or that the costs of a domestic adoption far exceed the costs of an international adoption. With smart marketing, the time to placement can be months and not years [though it is hard to gauge with more specificity] and costs – on average – are on a par with most international adoptions.

﻿﻿﻿Countries – indeed, whole regions of the world – which disallow or severely curtail IVF and/or gamete donation are often mistakenly called “highly regulated” environments. Heavy restrictions, usually with religious underpinnings or simply borne out of a failure to think progressively, hardly constitute regulation. They are more accurately described as prohibitions.

Compared with places like Italy, the Middle East, England and Canada (specifically with regard to paid gamete donation in these last two countries), the fertility industry in the United States has been likened to the “Wild West” – a loosely regulated landscape where anything is possible. This is just not true. The FDA, the mandates of various states vis a vis gamete donation (New York is prominent here), the ASRM (even though it oversteps its bounds with attempts at economic regulation) and the internal administrative policies of many responsible IVF clinics prove that significant regulation exists to shape appropriate conduct and safeguard the health of all IVF patients and egg/sperm donors. I think that we need better and more refined regulation so that we cut the lag time between scientific advancement and policies designed to effectively govern practice. But little regulation in the US? Not the case.

Pay egg donors for contributing to stem cell research? New York became the first in the United States to say yes:

New York has become the first and only state to opt to pay women for eggs donated for human embryonic stem cell research. The Empire State Stem Cell Board (ESSCB), which oversees New York’s $600 million stem cell research program that was launched last year, came to the decision last week (June 11) following “extensive deliberation” from its ethics committee. (“NY to pay for eggs for research,” TheScientist.com, June 17, 2009)

In an interesting twist, New York – a state that forbids compensated surrogacy – has now determined that it is acceptable (ethically) to compensate women for donating eggs to be used for clinical research. Perhaps the distinction is that legislators (I’d venture to guess from upstate territories) were behind New York’s statutory prohibition on commercial surrogacy, while more enlightened scientists and other interdisciplinary professionals who make up an ethical review board are behind this latest ruling. ASRM compensation and procurement guidelines will continue to control. A pioneering move sure to generate controversy.

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